Disaster Management

DISASTER MANAGEMENT PLAN Introduction In the past two decades, there have been many natural and man-made disasters in India. Natural disasters like floods, earthquakes, cyclones, droughts and human made such as terrorist acts, Nuclear or chemical war, fires and industrial accidents. Disasters can significantly lead to a degradation of social and economic progress achieved over decades of initiatives by the people. 80% of countries geographical area is disaster prone and the majority of people live at or below the poverty line. India has been devastated by three major disasters in last five years- Super Cyclone in Orissa, earthquake in Gujarat and now the latest one the tsunami in the Andaman and Nicobar Islands,. Tamilnadu, Andrapradesh and Kerala. Each disaster brought a great deal of miscarry to the affective population.

Definition of disaster Disaster is any occurrence arising with little or no warning, which causes ecology disruption, loss of human life, & deterioration of health services on a scale sufficient to warrant an extraordinary response from outside the community or area. ------ According to W.H.O.

Definition of disaster nursing Disaster nursing can be defined “as the adaptation of professional nursing skills in recognized & meeting the nursing, physical, &emotional needs resulting from a disaster. The overall goal of disaster nursing is to achieve the best possible level of health for the people & the community involved in the disaster.” ‘DISASTER’ alphabetically means: D - Destructions I - Incidents S - Sufferings A - Administrative, Financial Failures. S - Sentiments

T - Tragedies E - Eruption of Communicable diseases. R - Research programme and its implementation

Types of disaster 1. Natural disaster , 2. Manmade disaster, 3. Hybrid disaster. 1. Natural disaster: - e.g., Earthquake, floods, hurricane, tsunami. 2. Manmade disaster:-e.g., nuclear accidents, industrial accidents. 3. Hybrid disaster:-e.g., Spread of disease in community, global warning.

Causes of disaster & their impact on health Disaster & health problem The health problems in disaster could be due to either or any combination of factors given below;  Directly due to impact of drowning during floods, injuries during earth quake.  Due to delay in evacuation.  Due to non-availability or inadequate immediate medical care.  Due to disorganization or non-availability of centers for advanced medical care.  Due to delay in transportation of medical centers.

(Factors) Disaster Agents a) Primary agents: - including, heat, wind, rising water & smoke. b) Secondary agents:-include bacteria &viruses that produce contamination or infection after primary agents has caused injury or destruction.  Host:-Human kind Age, sex, immunization status, preexisting health degree of mobility emotional stability.

 Environment:-Physical factor e.g. Shelter ,food 

Chemical factors,

e.g.:-Industrial.

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Biological factors

e.g.:- Diseases, infection.

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Social factors,

e.g.:-Economical part

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Psychological factors e.g.:-Mental stress

Morbidity which can results from a disaster situation can be classified into four types:1. Injury 2. Emotional stress. 3. Epidemic of disease. 4. Increase in indigenous disease.

General principle of disaster management 1. Use of masks, rubber gloves, protective clothing while caring or handling such victims by all personnel. 2. Quick removal of victims to an uncontaminated area. 3. Substances of breathing through artificial breathing, 4. Thereafter removal of clothing & 5. Decontaminate eye & skin keeping in mind the chemical used. 6. Provide first aid to injure. 7. Evacuate the injured to medical facilities. 8. Provide definitive medical care. 9. Promote reconstruction of lives.

Levels of disaster  Level 3- considered a minor disaster. These are involves minimal level of damage.

 Level 2- considered a moderate disaster. The local & community resources has to manage this situation.  Level 1- considered a massive disaster- this involves a massive level of damage with severe impact.

Phases of disaster 

Prevention phase- Identify community preparedness for a disaster is only as high as the people & organization in the community make it.

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Preparedness phase – Personal preparedness, Professional preparedness.

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Response phase- The level of disaster varies & the management plans mainly based on the severity or extent of the disaster.

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Recovery phase – During this action are taken to repair, rebuilt, or reallocate damaged homes & business & restore health & economic vitality to the community.

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Psychological recovery must be addressed .Both victims & relief workers should be offered mental activities & services.

Disaster process Disaster situation is a process with different phases. IN each phase, the information, the action required, the problems uncounted & people involved may be quite different. Each type of phase will vary according to the type of disaster events.

Disaster Cycle

Prepare dness

Disaster impact

Mitigati on

Relief

Reconst ruction Dimensions of Disaster Disasters have different dimension like predictability, frequency, controllability time and scope or intensity. These dimensions influence the nature and possibility of preparation planning as well as response to the actual event. 

Predictability:Some events are easily predicted .Examples for predictable disasters is weather related

disasters like tornadoes, floods, hurricanes etc. 

Frequency:The natural disaster appears more often in certain geographical location. E.g. California

residents are at greater risk for earthquakes. 

Controllability:Some situations allow for pre-warning and control measures. That can reduce the impact of

disaster, E.g.in case-of flood redirecting the water etc. 

Time:-

There are several characteristics of time which relates to the impact of disaster, the speed of outlet of disaster time available for warming the population, actual length of time of the impact phases etc. 

Scope & intensity:A disaster may be concentrated on very small area or large, affecting may people. Disaster can

be very intensive & distracting causing many injuries, death, and property damage.

Nurse’s preparation to face disaster 

Personal Preparednesso Nurses with client responsibilities can also brome victims. o Conflict between family & work related responsibilities abound. The nurse assisting in disaster relief efforts must be as healthy as possible both physically & mentally. o A 3days supply of water o One change of clothing & footwear per person & one blanket or sleeping person. o A first aid kit that includes your family prescription medications. o An Extra set of car keys & credit cards, cash or traveler’s cheese. o Sanitation supplies, including toilet paper soap feminine hygiene items & Plastic garbage bags.

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Professional preparedness Adequately prepared nurses can function in a leadership capacity & assist towards smoother

recovery phase; Personal items that are recommended for nurses preparing to help in a disaster include the followingo Copy of professional license o Personal equipment such as stethoscope

o Flash light & extra batteries o Cash o Warm clothing & a heavy jacket for weather appropriate clothing o Record keeping materials o Pocket sized references books. o Disaster management is not high field work; including shelter management requires that nurses be creative willing to improvise in developing care.

Interventions in a Disaster Situations Disaster mitigation is a collective term used to encompass all activities undertaken in anticipation of the occurrence of a potentially disaster event including preparation & long term risk reduction measures mitigation activities including the following, o Awareness & education such as holding community meeting on disaster preparation. o Disaster relief such as building retaining walls to divert flood water away from a reside once. o Advocacy such as supporting actions & efforts for effective building codes & prudent land use.

Disaster management In disaster reconstitution of the following critical substrates is mandatory to restore institutional function. 1. Personnel. 2. The physical plant 3. Supplies & equipment 4. Communications

5. Supervision 6. Transportation The key to effective disaster management is pre disaster planning & preparation disaster. The principles of disaster planning have been but lined in a publication from civil Defense preparedness Agency. Department of defense includes the following – 

A continuous process

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A knowledge base

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A focus on principles

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Anticipatory guidance.

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Reducing unknown situations

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Evoking appropriate actions

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Overcoming resistance. Government, environmental, technical, & economic resources are involved in pre disaster

preparation. Community education & mock disaster exercises are part certain types of certain types of disaster especially to man made one.

Triage o Triage is a French word meaning sorting or categorizing. o During the disaster, the goal is to maximize the number of survivors by sorting, the treatable from the untreatable victims. o Prioritizing of victims for treatment can be done in many ways. American Red Cross (1982) gives color coding probably the best & most easily understood system is the first- priority, second priority, third priority, dying or dead system. 1. Red- most urgent - 1st priority These clients have reasonable chances of survival only if they receive immediate treatment.

This include victims with  Respiratory insufficiency  Cardiac arrest  Hemorrhage  Severe abdominal injury. 2. Yellow - 2nd priority These victims can wait for transportation after they receive initial emergency treatment. Victims include.  Immobilized closed fracture  Soft tissue injury without hemorrhage.  Burns less than 40% of the body. 3. Green - 3rd priority Victims in this category are ambulatory have minor tissue injuries & may be treated by nonprofessionals & held for observations if necessary. 4. Black - dying / dead. At the disaster site or primary triage point simple support measures can alleviate the psychological trauma experienced by survivors. These measures include the following.  Keeping families together, especially children with parents.  Provide adequate shelter food & rest.  Establishing & maintaining a communication network to reduce rumors.  Isolating victims who demonstrate hysterical or panic behavior. Nursing Care Goals for Disaster NursingHospital nurses will be needed to care for disaster victims as they are brought in for acute care problems.

Nurses Role at Emergency Aid  StationsNurses are involved in providing care at emergency aid stations. At least one registered nurse be present at all times while the emergency aid station is opened. The responsibilities of nurse in charge Arranging with volunteer medical consultant for initial & daily health checks based on the health needs of shelter residents.  Establishing nursing priority & planning for health care supervision.  Planning for appropriate transfer of patients to community health care facilities as necessary.  Evaluating health care needs.  Arranging for secure storage of supplies, equipment’s records & medications & periodically checking to see whether materials goods must be ordered.  Requesting & assigning volunteer staff to appropriate duties & providing on the job training & supervision.  Consultation with food supervisor regarding the preparation & distribution of special diets including infant’s formulas.  Planning & recommendation adequate staff &facilities when local health departments initiate an immunization program for shelter residents.  Arranging with the mass care supervisor for the purchases & replacement of essential prescription for persons in the shelter.  Establishing lines of communication with the health service officer. Training & drills:Mock exercise & drills at regular intervals are conducted to ensure that all the staff in the general & those associated with management of causalities are fully prepared & aware of their responsibilities.

Elements of disaster plan A disaster plan should have the following elements – 

Chain of authority

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Lines of communication

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Warning

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Evacuation

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Rescue & recovery

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Triage

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Treatment

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Support of victims & families

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Care of dead bodies

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Disaster worker rehabilitation.

Disaster Management -Nurses Role in Community 1) Assess the community Assessment The local climate conductive for disaster occurrence, past history of disaster in the community, available community disaster plans & resources, personnel available in the community for the disaster plans & management, local agencies & organizations involved in the disaster management activities. 2) Diagnose community disaster threats Determine the actual & potential disaster threats (e.g. explosion mass accidents, tornados, floods, earthquakes etc.) 3) Community disaster planning

o Develop a disaster plan to prevent or deal with identified disaster threats. o Identify local community communication system. o Identify disaster personnel, including, private and professional volunteers, local emergency personnel, agencies and resources. o Identify regional back up agencies and personnel o Identify specific responsibilities for various personnel involved in the disaster plans. o Set up an emergency medical system and chain for activation. o Identify location and accessibility of equipment and supplies. o Check proper functioning of emergency equipment o Identify outdated supplies and replenish for appropriate use. 4) Implement disaster plans o Focus on primary prevention activities to prevent occurrence of manmade disasters. o Practice community disaster plans with all personnel carrying out their previously identified responsibilities (e.g. emergency triage, providing supplies such as food, water, medicine ,crises and grief counseling) o Practice using equipment; obtaining and distributing supplies. 5) Evaluate effectiveness of disaster plan o Critically evaluate all aspect of disaster plans and practice drills for speed, effectiveness, gaps and revisions. o Evaluate the disaster impact on community and surrounding regions. o Evaluate the response of personnel involved in the disaster relief efforts. SUMMARY Up till now we are discussed about definition of disaster, types of disaster, causes of disaster and their impact on health, disaster agents, general principles of disaster management, level of disaster, phases of disaster, disaster process, disaster cycle, dimension of doisaster, nurses

preparation to face disaster, disasater management, triage, nurses role at emergency aid, element of doisaster plan and disaster management nurses role in community. CONCLUSION Providing information for disaster management is not effectively utilizing a wealth of information that resides with various organizations. Existing technologies could deliver to disaster managers important new information products that could save lives, reduce damage to property, and lessen the environmental impacts of natural disasters. Continued improvements in technology should help make information more widely, quickly, and reliably available and at less cost. The current situation is characterized by numerous shortcomings that inhibit optimal decision-making for disaster management. The inability to access information and the lack of standardization, coordination, and communication are all obstacles that a disaster information network could overcome.

BIBLIOGRAPHY

o P.K. Dave - Emergency medical services & disaster management. A Holistic Approach. Jaypee Brothers medical publisher (pvt) ltd. 2001. Page no.116-123. o Usha Ravindra Nair - Textbook of medical & surgical nursing.2009. Jaypee Brothers medical publisher (pvt) ltd. 2009. Page no 170-172. o Javed Ansari - Medical Surgical. 2012. Page no. 232-235. o Suresh Roy - Nurses Role in Disaster management. CBS Publishers & distributers. 2010. Page no. 11- 76. o Shebeer - A textbook of advance nursing Jaypee brother’s medical publisher (pvt) ltd. 2008. Page no.735-742. o http://nursingparadise.blogspot.in/2008/12/disaster-management-and-nurses-role.html

V.S.P.M’s COLLEGE OF NURSING AND RESEARCH CENTER, NAGPUR.

PLAN FOR DISASTER MANAGEMENT

SUBMITTED TO

SUBMITTED BY

Miss. Sarika Bais

Miss. Kalyani Rawale

Lecturer,

M.Sc. final year nursing,

V.S.P.M’s CON &RC,

V.S.P.M’s CON &RC,

Nagpur.

Nagpur.

SUBMITTED ON 19/01/2017